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Getting baby to sleep? Feeding/pumping issues

So, LO was born at 33wks0days, and was in the NICU for 10 days. During that time we attempted to BF at 2 feedings every day and he was fed every 3 hours, slowly ramped up to getting 80mL every 3 hours. At the time that he was down at 45mL per feed, once he got 41g from me (they measure 1g = 1mL for pre/post weights) which was almost good enough. He's always been a good eater, no tubes, and eats bottles like a champ, pretty fast.

When we brought him home they said to feed on demand, and depending on how much I thought he got, give bottles to supplement. (I am pumping at every feed, so I have quite a stockpile of milk, so it's all my milk - he was only given formula on the first day, then donor milk, and after day 6 only my milk.) He didn't gain enough for his first visits, and the doctor we saw said he *had* to have 80mL per feeding every 3 hours (which was huge for him... he was at 70 every 3 hours in the NICU and upping to 80 was SO HARD.) I had to forcefeed him sometimes.

Then we saw another pediatrician (his actual doctor) for the first time, and she realized he had gained TOO much on that schedule, so we could back off. Suggestion was to get a scale and measure how much he ate. Then, we still fed every 3 hours, but only supplemented if he took less than 60g, and supplemented up to 80 (giving him the option of getting to 80 by bottle.) During that time he did naturally eat 90 once and 100 once from the breast. He did well and now we're more "on our own". I still pump after every session because they made me feel that it could cause a supply problem otherwise. (Have a hospital rental)

The biggest problem for me is, he is allowed to go for long spells at night so long as he still gets his amounts, his diaper numbers etc. But at night it's the worst. He wants to feed so frequently, I have been trying to hold out for him to feed no more frequently than 2.5 hours, but it's really rough trying to feed - bottle - diaper - pump - SLEEP??? and during the day he'd love to go long hours of sleep (4, 4.5 hours between feeds easily.) I'm trying to make him eat every 3 hours during the day to encourage the night sleeping but it doesn't seem to happen.

I also really want to get to let up on the pumping, but everyone has told me it takes 6-8 weeks to really set in the supply well. But the whole feeding/diapering/pumping routine, when he eats enough not to need a bottle, takes an hour minimum, although I rarely pump more than 10 minutes unless he refused the breast.

He usually feeds completely from the breast about 5 feedings a day, refuses the breast for 1, and has 2-3 feedings where he takes a bottle to supplement...

Please, suggestions. During the day my body has a hard time sleeping, even though I need it, so I want to figure out how to get him to take his long breaks at night. He is 4 weeks today, his due date was Jan 28, he was born Dec 10, and we have been home since Dec 21.

Re: Getting baby to sleep? Feeding/pumping issues

Can you cut out all the pumping, bottle feeding and diapering at night and just focus on nursing? That should help you get more sleep. I know when I was dealing with low supply with my first child, I was ready to pack it in until I just decided to stop pumping at night - that was what had been really killing me. You can do whatever is necessary with respect to supplementing during the day - and wake at least every 2 hours to eat during the day. I think that would work out better (both for sleep and for making sure your baby is getting enough) than trying to stretch out night feedings. Has your pediatrician talked with you about an overall plan for weaning from the supplements? You may want to meet with a lactation consultant to work that part out.

Re: Getting baby to sleep? Feeding/pumping issues

Wow, this is so hard! Having a preemie and all these doctors and nurses telling you things you have to do -- it's just scary. Good for you on getting him so much of your milk! His body was designed to get it, so this is the best medicine you could give your preemie

- Many moms find that when they watch the clock and try to hold a baby off, their milk supply (and their sanity and their baby's mood!) suffer. Nursing any time your baby wants is the best thing for him and for your milk supply. Nursing not only helps your baby get milk, but also fills another need: his need to be close to you, which is as real and as intense as his need for food. So if he seems "hungry" because he's wanting to nurse more often, it might just be that he really likes his momma! Anyway, the milk supply system was designed to have these short, frequent nursings.

- Sounds like he is doing just fine getting milk without the pump. Some preemies simply aren't strong/efficient enough to extract enough milk from mom to maintain a milk supply. It doesn't sound like that's the case with you -- yeah!!! I suspect you would probably need to "wean" yourself off the pump, since you are kind of making enough milk for twins right now: your baby and the pump! So if you're feeling full or starting to get hard spots -- try nursing your baby again, but if he won't then pump!

- Getting more rest at night can be helpful when you sleep next to or near your baby. There are natural hormones released when you are close to your baby and while you are nursing, that help you sleep. This can help during the day, too!

- Any ideas as to why he is refusing the breast? What's going on with that?